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This is a Bill, not an Act. For current law, see the Acts databases.
1998-1999-2000
The Parliament
of the
Commonwealth of
Australia
HOUSE OF
REPRESENTATIVES
Presented and read a first
time
National
Health Amendment (Improved Monitoring of Entitlements to Pharmaceutical
Benefits) Bill 2000
No. ,
2000
(Health and Aged
Care)
A Bill for an Act to amend the
National Health Act 1953 to improve the monitoring of entitlements to
pharmaceutical benefits, and for related purposes
ISBN: 0642 452520
Contents
A Bill for an Act to amend the National Health Act
1953 to improve the monitoring of entitlements to pharmaceutical benefits,
and for related purposes
The Parliament of Australia enacts:
This Act may be cited as the National Health Amendment (Improved
Monitoring of Entitlements to Pharmaceutical Benefits) Act 2000.
This Act commences on the day on which it receives the Royal
Assent.
Each Act that is specified in a Schedule to this Act is amended or
repealed as set out in the applicable items in the Schedule concerned, and any
other item in a Schedule to this Act has effect according to its
terms.
1 Subsection 84(1)
Insert:
communicated prescription means a prescription that is
communicated to an approved pharmacist in the circumstances and manner set out
in regulations made for the purposes of paragraph 89(a).
2 Subsection 84(1)
Insert:
expiry date, in relation to a medicare number,
means:
(a) if the number is recorded on a medicare card that specifies a
particular date on which the card expires—that date; and
(b) if the number is recorded on a medicare card that does not specify a
particular date on which the card expires but that has recorded on it the month
at the end of which the card expires—the last day of that month;
and
(c) if the number is not of a kind referred to in paragraph (a) or
(b)—such date as the Minister specifies, in writing, in respect of the
number.
3 Subsection 84(1)
Insert:
medicare card means:
(a) a card issued by the Health Insurance Commission and commonly known as
a medicare card; or
(b) a card or written authorisation provided to a person that evidences a
person’s eligibility for pharmaceutical benefits under the scheme known as
the Repatriation Pharmaceutical Benefits Scheme established under the
Veterans’ Entitlements Act 1986; or
(c) any other card that is prescribed for the purposes of this
definition.
4 Subsection 84(1)
Insert:
medicare number means:
(a) in relation to a particular person covered by a medicare
card—the particular combination of numbers, or letters and numbers, on the
card that is applicable only to that person as a person covered by that card;
and
(b) in relation to a person who the Health Insurance Commission is
satisfied is, or is entitled to be treated as, an eligible person within the
meaning of the Health Insurance Act 1973 but who is not covered by a
medicare card—the particular combination of numbers, or letters and
numbers, that would be applicable to that person if that person were covered by
a medicare card.
5 Subsection 84(1)
Insert:
special number, in relation to a particular person who is
included within a class of persons identified by the Minister in a determination
under subsection 86E(1)—the particular combination of numbers, or letters
and numbers, allocated in accordance with a procedure set out in that
determination, that is applicable to that person as a person included in that
class.
6 At the end of
section 84
Add:
(8) A reference in this Part to the provision to a person or body of a
medicare number as a number applicable to a particular individual is a reference
to:
(a) the production to that person or body of a medicare card having on it
a medicare number as a number applicable to that particular individual;
or
(b) the provision to that person or body of any other information, whether
documentary or oral, that indicates a medicare number as a number applicable to
that particular individual.
(9) A reference in this Part to the provision to a person or body of the
expiry date in relation to a medicare number provided as a number applicable to
a particular individual is a reference to:
(a) the production to the person or body of a medicare card that indicates
the expiry date in relation to that medicare number; or
(b) the provision to the person or body of any other information, whether
documentary or oral, that indicates the expiry date in relation to that medicare
number.
(10) A reference in this Part to a medicare number, or special number,
that ultimately appears on a prescription is a reference to that number in the
form in which it appears on the prescription (or in the case of a communicated
prescription, the written version of that prescription) at the time when the
prescription is sent to the Health Insurance Commission by an approved supplier
with a claim for payment.
7 Section 86
Repeal the section, substitute:
Subject to this Part, a person who:
(a) is, or is to be treated as, an eligible person within the meaning of
the Health Insurance Act 1973; and
(b) is receiving medical treatment by a medical practitioner or dental
treatment by a participating dental practitioner;
is entitled to receive pharmaceutical benefits under this Part without the
payment or furnishing of money or other consideration other than a charge made
in accordance with section 87.
An approved supplier must not supply a pharmaceutical benefit in respect
of a person if the approved supplier has reason to believe that the person is
not in Australia at the time of the supply.
Approved supplier may request provision of medicare number
(1) If:
(a) an approved supplier is presented with a prescription for the supply
of a pharmaceutical benefit to a person; and
(b) the person presenting the prescription claims to be, or to be the
agent of, the person to whom the prescription relates; and
(c) the person presenting the prescription does not request that the drug
or medicinal preparation to which the prescription relates not be supplied as a
pharmaceutical benefit;
the approved supplier may request the person presenting the prescription to
provide to the approved supplier a medicare number applicable to the person to
whom the prescription relates and the expiry date in relation to the
number.
Inclusion of medicare number in a prescription does not prevent later
request
(2) The approved supplier may make the request under subsection (1)
whether or not:
(a) the prescription already contains a medicare number as a number
applicable to the person to whom the prescription relates; or
(b) the approved supplier’s records already contain such a number
(whether with or without the expiry date in relation to that number) recorded
and retained in accordance with section 86D.
Checking and endorsement powers if medicare number is
provided
(3) If a medicare number is provided to the approved supplier as a number
applicable to the person following a request under subsection (1), or is
included as such a number in the approved supplier’s records in accordance
with section 86D, the approved supplier may:
(a) if the prescription has already been endorsed with a medicare number
as such a number, check the number so provided or included against the endorsed
number and:
(i) confirm that they are the same; or
(ii) if they are not the same and the approved supplier considers the
number so provided or included more reliable than the endorsed
number—alter the endorsed number to the number so provided or included;
or
(iii) if they are not the same and the approved supplier considers the
endorsed number more reliable than the number so provided or
included—disregard the number so provided or included; and
(b) if the prescription has not already been endorsed with a medicare
number as such a number—endorse the prescription with the medicare number
so provided or included as a number applicable to the person; and
(c) if the approved supplier has also been provided with, or has, in the
approved supplier’s records, the expiry date in relation to the medicare
number ultimately appearing on the prescription—confirm that the supply of
a pharmaceutical benefit authorised by the prescription is not being sought
after the expiry date.
Endorsement power in respect of prescription (other than communicated
prescription) covering person included in class determined under subsection
86E(1).
(4) If:
(a) the prescription for the supply of a pharmaceutical benefit that is
presented to the approved supplier does not contain a medicare number as a
number applicable to the person to whom the prescription relates; and
(b) despite a request under subsection (1), a medicare number is not
provided to the approved supplier as such a number; and
(c) a medicare number is not retained in the approved supplier’s
records in accordance with section 86D as such a number; and
(d) the approved supplier is satisfied that the person to whom the
prescription relates is included within a class of persons identified by the
Minister under subsection 86E(1);
the approved supplier may endorse on the prescription the special number
applicable to the person as a member of that class.
Endorsement power in respect of written version of communicated
prescription not containing medicare number
(5) If:
(a) a prescription for the supply of a pharmaceutical benefit is not
presented to an approved supplier as described in subsection (1) but is
communicated to the approved supplier in circumstances set out in regulations
made for the purposes of paragraph 89(a); and
(b) the approved supplier later receives a written version of the
prescription that does not contain a medicare number as a number applicable to
the person to whom the prescription relates;
the approved supplier may endorse on the written version of that
prescription when the written version is received:
(c) if a medicare number is already retained in the approved
supplier’s records in accordance with section 86D as a number
applicable to the person to whom the prescription relates—that medicare
number; or
(d) if a medicare number is not so retained as a number applicable to the
person to whom the prescription relates—the special number applicable to
the person under subsection 86E(1) as a person in respect of whom a prescription
has been so communicated.
Approved supplier must request provision of medicare numbers in certain
circumstances
(1) If:
(a) an approved supplier is presented, on or after 1 January 2001,
with a prescription for the supply of a pharmaceutical benefit to a person;
and
(b) the pharmaceutical benefit is one in respect of the supply of which
the approved supplier would, but for the operation of subsection 99(7), be
entitled to receive a payment under subsection 99(2) or (4); and
(c) the person presenting the prescription claims to be, or to be the
agent of, the person to whom the prescription relates; and
(d) the person presenting the prescription does not request that the drug
or medicinal preparation to which the prescription relates not be supplied as a
pharmaceutical benefit;
the approved supplier must, if:
(e) the prescription does not contain a medicare number as a number
applicable to the person to whom the prescription relates; and
(f) the approved supplier’s records do not already contain a
medicare number as such a number (whether with or without the expiry date in
relation to that number) recorded and retained in accordance with
section 86D;
request the person presenting the prescription to provide to the approved
supplier a medicare number applicable to the person to whom the prescription
relates and the expiry date in relation to that number.
Inclusion of medicare number in a prescription does not prevent later
request
(2) Even if:
(a) the prescription presented to the approved supplier already contains a
medicare number as a number applicable to the person to whom the prescription
relates; or
(b) the approved supplier’s records already contain a medicare
number as such a number (whether with or without the expiry date in relation to
that number) recorded and retained in accordance with
section 86D;
the approved supplier may request the person presenting the prescription to
provide to the approved supplier a medicare number applicable to the person to
whom the prescription relates and the expiry date in relation to that
number.
Endorsement requirement if medicare number is provided
(3) If:
(a) a medicare number is provided to the approved supplier as a number
applicable to the person to whom the prescription relates following a request
under subsection (1) or is included as such a number in the approved
supplier’s records in accordance with section 86D; and
(b) the prescription has not already been endorsed with a medicare number
as a number applicable to the person to whom the prescription relates;
the approved supplier must endorse the prescription with the medicare
number so provided or included.
If medicare number is provided approved supplier may check prescription
endorsed by practitioner
(4) If:
(a) a medicare number applicable to the person to whom the prescription
relates is provided to the approved supplier following a request under
subsection (2) or is included in the approved supplier’s records in
accordance with section 86D; and
(b) the prescription has already been endorsed with a medicare number as a
number applicable to the person to whom the prescription relates;
the approved supplier may check the number so provided or included against
the endorsed number and:
(c) confirm that they are the same; or
(d) if they are not the same and the approved supplier considers the
number so provided or included more reliable than the endorsed
number—alter the endorsed number to the number so provided or included;
or
(e) if they are not the same and the approved supplier considers the
endorsed number more reliable than the number so provided or
included—disregard the number so provided or included.
Approved supplier may check to ensure that supply not being sought after
relevant expiry date
(5) If the approved supplier has also been provided with, or has in the
approved supplier’s records, the expiry date in relation to the medicare
number ultimately appearing on the prescription, the approved supplier may
confirm that the supply of the pharmaceutical benefit authorised by the
prescription is not being sought after the expiry date.
Endorsement requirement in respect of prescription (other than
communicated prescription) covering person included in class determined under
subsection 86E(1).
(6) If:
(a) the prescription for the supply of a pharmaceutical benefit that is
presented to the approved supplier does not contain a medicare number as
a number applicable to the person to whom the prescription relates;
and
(b) despite a request under subsection (1), a medicare number is not
provided to the approved supplier as such a number; and
(c) a medicare number is not retained in the approved supplier’s
records in accordance with section 86D as such a number; and
(d) the approved supplier is satisfied that the person to whom the
prescription relates is included within a class of persons identified by the
Minister in a determination under subsection 86E(1);
the approved supplier must endorse on the prescription the special number
applicable to the person as a member of that class.
Endorsement requirement in respect of written version of communicated
prescription not containing medicare number
(7) If:
(a) a prescription for the supply of a pharmaceutical benefit is not
presented to an approved supplier as described in subsection (1) but is
communicated to the approved supplier in circumstances set out in regulations
made for the purposes of paragraph 89(a); and
(b) the pharmaceutical benefit is one in respect of the supply of which
the approved supplier would, but for the operation of subsection 99(7), be
entitled to receive a payment under subsection 99(2) or (4); and
(c) the approved supplier later receives a written version of the
prescription that does not contain a medicare number as a number applicable to
the person to whom the prescription relates;
the approved supplier must endorse on the written version of that
prescription, when it is received:
(d) if a medicare number is already retained in the approved
supplier’s records in accordance with section 86D as a number
applicable to the person to whom the prescription relates—that medicare
number; or
(e) if a medicare number is not so retained as a number applicable to the
person to whom the prescription relates—the special number applicable to
the person under subsection 86E(1) as a person in respect of whom a prescription
has been so communicated.
Note 1: The consequences of a failure to ensure that a
prescription presented or communicated on or after 1 July 2001 contains a
medicare number or special number are set out in subsection
99(7).
Note 2: If, because a medicare number is not provided and a
special number is not applicable, a person pays the full amount to an approved
supplier for the supply of a pharmaceutical benefit, the person may be entitled
to an appropriate refund from the Commonwealth (see subsection
87A(2)).
Approved supplier may record and retain medicare numbers and expiry
dates supplied by or on behalf of patients
(1) If:
(a) an approved supplier is provided with a medicare number as a number
applicable to a person (whether with or without the expiry date in relation to
that number) either:
(i) as a result of a request under section 86B or 86C; or
(ii) to facilitate the supply of pharmaceutical benefits at a later time
or times; and
(b) the approved supplier is satisfied that the person providing the
number, or number and date, is:
(i) the person in respect of whom the number was provided; or
(ii) the legal guardian of that person; or
(iii) another person who, in accordance with a written determination made
by the Minister for the purposes of this subsection, is capable of giving an
authorisation under this subsection;
the approved supplier may, with the authorisation of the person providing
the number, or number and date, undertake the permitted recording and retention
activities in relation to that number, or number and date.
Supplier may record and retain medicare numbers and expiry dates
supplied by medical practitioners or participating dental practitioners in
respect of communicated prescriptions
(2) If:
(a) a prescription for the supply of a pharmaceutical benefit is
communicated to an approved supplier in circumstances set out in regulations
made for the purposes of paragraph 89(a); and
(b) at the time the prescription is communicated, the medical practitioner
or participating dental practitioner communicating the prescription informs the
approved supplier of a medicare number as a number applicable to the person to
whom the prescription relates (whether with or without the expiry date in
relation to that number);
the approved supplier may undertake the permitted recording and retention
activities in relation to that number, or number and date.
Note: An approved supplier can only be informed of a
medicare number under this section with the authority of the person whose number
it is, or of another person on that person’s behalf (see subsection
88(3B)).
Persons not obliged to authorise recording and retention of
particulars
(3) Nothing in this section implies that a person is under any obligation
to authorise an approved supplier to undertake the permitted recording and
retention activities in respect of a medicare number, or of a medicare number
and the expiry date in relation to such a number, provided as a result of a
request under section 86B or 86C.
Approved supplier responsible for storage and security
(4) An approved supplier who, under this section, records and retains
medicare numbers, or medicare numbers and expiry dates in relation to those
numbers, in the approved supplier’s records must ensure:
(a) that the record of those numbers, or numbers and dates, is protected,
by such security safeguards as it is reasonable in the circumstances to take,
against loss, against unauthorised access, use, modification or disclosure, and
against other misuse; and
(b) if it is necessary for access to the record of those numbers, or
numbers and dates, to be given to a person in connection with the provision of
services to the approved supplier—that everything reasonably within the
power of the approved supplier is done to prevent unauthorised use or disclosure
of information contained in that record.
Determinations are disallowable instruments
(5) Ministerial determinations for the purposes of subsection (1) are
disallowable instruments within the meaning of section 46A of the Acts
Interpretation Act 1901.
Permitted recording and retention activities
(6) In this section:
permitted recording and retention activities,
in relation to a medicare number provided to an approved supplier under
subsection (1) or (2) as a number applicable to a person (whether with or
without an expiry date in relation to that number), are:
(a) to record and retain that number, or that number and date, in the
approved supplier’s records in relation to that person; or
(b) if the approved supplier has already recorded and retained either or
both of those particulars in relation to that person by virtue of a previous
operation of this section—to check the accuracy and completeness of the
recorded particulars in respect of that person and, if the recorded particulars
are inaccurate or incomplete, to modify those particulars
appropriately.
Determination of classes of persons whose entitlement to pharmaceutical
benefits can be evidenced otherwise than by provision of medicare
numbers
(1) The Minister may, by written instrument, determine that certain
classes of persons are classes of persons in respect of whom an entitlement to
pharmaceutical benefits can be evidenced otherwise than by provision of a
medicare number.
Classes that may be the subject of a determination
(2) Without limiting the classes that may be so determined, those classes
may include the following:
(a) persons who are not legally competent;
(b) persons requiring drugs or medicinal preparations in an
emergency;
(c) foreign persons:
(i) who are entitled to be treated as eligible persons within the meaning
of the Health Insurance Act 1973 under section 7 of that Act;
and
(ii) who are able to produce evidence, of a kind specified in the
determination, to prove that entitlement;
(d) persons in respect of whom a prescription is communicated in
circumstances set out in regulations made for the purposes of paragraph
89(a).
Determinations may set out particulars of which suppliers must be
satisfied
(3) In a determination under subsection (1), the Minister may set
out:
(a) the particular matters in respect of which an approved supplier must
be satisfied before being satisfied that a person is included within a
particular class determined under that subsection; and
(b) the procedure to be followed by the approved supplier in establishing
such matters.
Determinations under subsection (1) must establish procedure for
allocation of special numbers
(4) The Minister must include, in each determination under
subsection (1) that identifies a class of persons, a procedure for
allocating a particular combination of numbers, or letters and numbers, that is
to be the special number applicable to a person included within that class as a
member of that class.
Determinations are disallowable instruments
(5) Ministerial determinations under subsection (1) are disallowable
instruments within the meaning of section 46A of the Acts Interpretation
Act 1901.
8 After subsection 88(3)
Insert:
(3A) A medical practitioner or a participating dental practitioner, when
writing or communicating a prescription for the supply of a pharmaceutical
benefit to a person, may:
(a) request the provision of a medicare number applicable to the person
and of the expiry date in relation to that number; and
(b) if a medicare number (whether with or without the expiry date in
relation to that number):
(i) is so provided as a number applicable to the person; or
(ii) is retained as such a number in the practitioner’s records in
accordance with section 88AA;
endorse the medicare number on a prescription written for that person
(including, in the case of a communicated prescription, a subsequent written
version of that communicated prescription).
(3B) A medical practitioner or a participating dental practitioner must
not inform an approved supplier of a medicare number, or a medicare number and
an expiry date in relation to that number, in the circumstances described in
subsection 86D(2), unless:
(a) the person in respect of whom the number was provided; or
(b) the legal guardian of that person; or
(c) another person identified in a determination made by the Minister
under section 86D or 88AA as capable of authorising the recording and
retention of such number or number and date;
authorises the practitioner to inform the approved supplier of that number,
or number and date.
(3C) Nothing in this section implies that a person is under any
obligation:
(a) to provide a medicare number, or a medicare number and the expiry date
in relation to that number, to a medical practitioner or a participating dental
practitioner; or
(b) to authorise such a practitioner to inform an approved supplier of
such a number, or number and date, in the circumstances described in subsection
86D(2).
9 After section 88
Insert:
(1) If:
(a) a medical practitioner or a participating dental practitioner is
provided with a medicare number as a number applicable to a person (whether with
or without the expiry date in relation to that number) either:
(i) as a result of a request under subsection 88(3A); or
(ii) to facilitate the writing of a prescription for the supply of
pharmaceutical benefits at a later time or times; and
(b) the practitioner is satisfied that the person providing the number, or
number and date, is:
(i) the person in respect of whom the number was provided; or
(ii) the legal guardian of that person; or
(iii) another person who, in accordance with a written determination made
by the Minister for the purposes of this subsection, is capable of giving an
authorisation under this subsection;
the practitioner may, with the authorisation of the person providing the
number, or number and date:
(c) record and retain that number, or number and date, in the
practitioner’s records; or
(d) if the practitioner has already recorded and retained either or both
of those particulars by virtue of a previous operation of this
section—check the accuracy and completeness of the recorded particulars
and, if the recorded particulars are inaccurate or incomplete, appropriately
modify those particulars.
(2) Nothing in subsection (1) implies that a person is under any
obligation to authorise the recording and retention, in a practitioner’s
records, of a medicare number, or of the expiry date in relation to such a
number, provided as a result of a request under subsection 88(3A).
Practitioner responsible for storage and security
(3) A medical practitioner or a participating dental practitioner who,
under this section, records and retains medicare numbers, or medicare numbers
and expiry dates in relation to those numbers, in the practitioner’s
records must ensure:
(a) that the record of those numbers, or numbers and dates, is protected,
by such security safeguards as it is reasonable in the circumstances to take,
against loss, against unauthorised access, use, modification or disclosure, and
against other misuse; and
(b) that if it is necessary for access to the record of those numbers, or
numbers and dates, to be given to a person in connection with the provision of
services to the practitioner, everything reasonably within the power of the
practitioner is done to prevent unauthorised use or disclosure of information
contained in that record.
(4) Ministerial determinations for the purposes of subsection (1) are
disallowable instruments within the meaning of section 46A of the Acts
Interpretation Act 1901.
10 At the end of
section 99
Add:
(7) An approved supplier is not entitled:
(a) if the supplier is an approved pharmacist or an approved medical
practitioner—despite subsection 99(2); and
(b) if the supplier is an approved hospital authority—despite
subsection 99(4);
to be paid by the Commonwealth for the supply of a pharmaceutical benefit
to a person on a prescription presented to the approved supplier on or after
1 July 2001 unless:
(c) there ultimately appears on the prescription a medicare number, or a
special number, as a number applicable to the person to whom the prescription
relates; and
(d) if the number so appearing is such a medicare number—that
medicare number corresponds with a medicare number that is held in the records
of the Health Insurance Commission as a number applicable to that
person.
(8) If:
(a) an approved supplier has supplied a pharmaceutical benefit in
accordance with a prescription presented to that supplier; and
(b) the pharmaceutical benefit has been supplied to a person to whom
paragraph (a), (b), (ba), (c) or (d) of the definition of Australian
resident in subsection 3(1) of the Health Insurance Act 1973
applies; and
(c) there ultimately appears on the prescription a medicare number as a
number applicable to the person to whom the prescription relates; and
(d) that medicare number does not correspond with a medicare number that
is held in the records of the Health Insurance Commission as a number applicable
to that person; and
(e) the sole reason that there is no such correspondence is that the
number on the prescription had expired within 60 days, or such other period as
the Minister determines, preceding the date of the supply;
then, whether or not a new medicare number has been allocated to the person
to whom the prescription relates since the expiry date of the number on the
prescription, and despite paragraph (3)(a), the approved supplier is as
entitled to payment in respect of that supply as would have been the case if the
number on the prescription:
(f) had not expired; and
(g) had continued to correspond with a medicare number that is held in the
records of the Health Insurance Commission as a number applicable to the
person.
(9) Ministerial determinations for the purposes of subsection (8) are
disallowable instruments within the meaning of section 46A of the Acts
Interpretation Act 1901.
11 After section 135A
Insert:
(1) If:
(a) a medicare number, or a medicare number and the expiry date in
relation to that number, are provided, as a result of a request under
section 88, or under section 88AA, to a person who is a medical
practitioner or participating dental practitioner; and
(b) that number, or number and date, are provided solely for either or
both of the following purposes:
(i) enabling the person to write or communicate a prescription for the
supply of a pharmaceutical benefit;
(ii) enabling the person to record and retain that number, or number and
date, to facilitate the writing of future prescriptions for the supply of
pharmaceutical benefits;
the person is guilty of an offence if, while the person is, or after the
person ceases to be, such a practitioner, the person directly or indirectly
makes an unauthorised disclosure or an unauthorised use of that number or that
date.
Penalty: 50 penalty units or imprisonment for 2 years, or both.
(2) For the purposes of subsection (1):
(a) the disclosure by a person referred to in that subsection of a
medicare number, or of the expiry date in relation to a medicare number, to
another person is an unauthorised disclosure of that number or that date;
and
(b) the use by a person referred to in that subsection of a medicare
number, or of the expiry date in relation to a medicare number, is an
unauthorised use of that number or that date;
if that disclosure or use is not made or undertaken:
(c) in the performance of the duties, or in the exercise of the powers or
functions, of that person as a medical practitioner or participating dental
practitioner under this Act in relation to the Pharmaceutical Benefits Scheme;
or
(d) for the purpose of enabling a person to perform functions under the
Health Insurance Commission Act 1973 in relation to the that
Scheme.
(3) If:
(a) a medicare number, or a medicare number and the expiry date in
relation to that number, are provided, as a result of a request under
section 86B or 86C, or under section 86D, to a person or body that is
an approved supplier; and
(b) that number, or number and date, are provided solely for one or more
of the following purposes:
(i) enabling the person or body to supply a pharmaceutical
benefit;
(ii) enabling the person or body to record and retain that number, or
number and date, in order to facilitate the supply of pharmaceutical benefits at
a later time or times;
(iii) enabling the person or body to record and retain that number, or
number and date, in order to complete the written version of a prescription that
has been previously communicated;
the person or body is guilty of an offence if, while the person or body is,
or after the person or body ceases to be, such an approved supplier, the person
or body directly or indirectly makes an unauthorised disclosure or an
unauthorised use of that number or that date.
Penalty: 50 penalty units or imprisonment for 2 years, or both.
(4) For the purposes of subsection (3):
(a) the disclosure by a person or body referred to in that subsection of a
medicare number, or of the expiry date in relation to a medicare number, to
another person is an unauthorised disclosure of that number or that date;
and
(b) the use by a person or body referred to in that subsection of a
medicare number or of the expiry date in relation to a medicare number is an
unauthorised use of that number or that date;
if that disclosure or use is not made or undertaken:
(c) in the performance of the duties, or in the exercise of the powers or
functions, of the person or body as an approved supplier under this Act in
relation to the Pharmaceutical Benefits Scheme; or
(d) for the purpose of enabling a person to perform functions under the
Health Insurance Commission Act 1973 in relation to that
Scheme.
(5) If a medicare number, or a medicare number and the expiry date in
relation to that number, are provided:
(a) to a person who is employed or engaged by:
(i) a medical practitioner or participating dental practitioner;
or
(ii) a company that provides services in support of a medical practitioner
or participating dental practitioner;
solely for a purpose or purposes referred to in paragraph (1)(b);
or
(b) to a person who is employed or engaged by:
(i) an approved supplier; or
(ii) a company that provides services in support of an approved
supplier;
solely for a purpose or purposes referred to in
paragraph (3)(b);
that person is, while the person is, and after the person ceases to be, so
employed or engaged, subject to the same obligations and liabilities as apply
under subsection (1) or (3), as the case requires, in relation to the
person or body by whom the person is or was so employed or engaged.
(6) A person to whom a medicare number, or a medicare number and the
expiry date in relation to that number, are disclosed in contravention of
subsection (1), (3) or (5) is guilty of an offence if:
(a) the person knows or ought reasonably to know that the disclosure of
the number, or number and date, was in contravention of that subsection;
and
(b) the person directly or indirectly discloses that number or that date
to any person, or otherwise makes use of that number or that date.
Penalty: 50 penalty units or imprisonment for 2 years, or both.
(7) Despite subsection (1), (3) or (5), a person or body to whom a
medicare number, or a medicare number and the expiry date in relation to that
number, are provided solely for a purpose set out or referred to in that
subsection may disclose that number or expiry date to another person for another
specified purpose with the express authority of:
(a) the person in respect of whom that number was provided; or
(b) the legal guardian of that person; or
(c) another person identified in a determination made by the Minister
under section 86D or 88AA as capable of authorising the recording and
retention of such number or number and date, on behalf of the person to whom the
number applies.
(8) A person to whom a medicare number, or a medicare number and the
expiry date in relation to that number, are disclosed in accordance with an
express authority under subsection (7) is guilty of an offence if the
person:
(a) directly or indirectly discloses that number or that date to another
person; or
(b) makes use of that number or that date;
other than for the purpose specified by the person giving the
authority.
Penalty: 50 penalty units or imprisonment for 2 years, or both.
(9) Nothing in subsection (1), (3), (5), (6) or (8) prevents a
medicare number or an expiry date in relation to such a number from being
communicated to a court for the purpose of proceedings under this
section.
(10) In this section:
approved supplier has the same meaning as in
Part VII.
expiry date, in relation to a medicare number,
has the same meaning as in Part VII.
medicare number, in relation to a person, has the same
meaning as in Part VII.
participating dental practitioner has the same meaning as in
Part VII.
(11) A reference in this section to a number, or number and
date, provided to an approved supplier or to a person engaged or employed by an
approved supplier, includes a reference to such a number, or number and date,
that are informed under section 86D to the approved supplier by a medical
practitioner or a participating dental practitioner communicating a prescription
to the supplier.
12 After subsection
135AA(5)
Insert:
(5A) Nothing in this section, or in the guidelines issued by the Privacy
Commissioner, precludes the inclusion, in a database of information held by the
Health Insurance Commission and relating to claims for benefits under the
Pharmaceutical Benefits Program, of the pharmaceutical entitlements number
applicable to the person to whom each such claim relates:
(a) as a person covered by a benefit entitlement card; or
(b) as a person included within a class identified by the Minister in a
determination under subsection 86E(1).
13 Subsection 135AA(11)
Insert:
benefit entitlement card means:
(a) a medicare card within the meaning of subsection 84(1); and
(b) a card that evidences the person’s status as a concessional
beneficiary within the meaning of subsection 84(1).
14 Subsection 135AA(11)
Insert:
pharmaceutical entitlements number, in relation to a person,
means:
(a) if the person is covered by a medicare card—a medicare number
within the meaning of subsection 84(1) that is applicable to the person as a
person covered by that card; and
(b) if the person is covered by a card that evidences the
person’s status as a concessional beneficiary within the meaning of
subsection 84(1)—the number applicable to that person as a person covered
by that card.